How Much Is Enough?

When I first started fertility treatment, a friend of mine said something to me that didn’t sink in until … well, last week.

“Maybe it’s not that people think they know better than you, when they say you’ll get IVF,” she said. “Maybe it’s just that they’ve been there, and they’ve seen how things sort of progress, no matter what their original intentions were. Like, they thought they were going to do artificial insemination, three rounds, tops, but then six months later they were pregnant with twins after their second round of IVF.”

It was easy for me to pooh-pooh what she said, because she had never been through fertility treatments, but I should have listened. Because this month, I started to see how people get started rolling down that hill, from IUI with oral medications to IUI with injectable medications to IVF and so on. [Please note: I have not changed my mind about doing IVF, and I’m still doing fine without extra advice on our fertility situation, in case you’re composing an email to me in your mind as you read.]

“Just a little bit farther. What’s the worst that could happen?”

That’s because this month, I moved to injectable meds, and had such a “strong response,” as the doctors put it, I had to cancel my cycle, lest I wind up pregnant with octuplets. That put me in a weird spot, and not just because my ovaries were swollen to what felt like five times their normal size and my hormones were making me depressed and ragey.

See, before this particular round, I’d decided that this was the last-ditch effort. That might sound early, especially to people who’ve gone through multiple IUI and IVF cycles, but it was one more than I thought I had in me after our Clomid round in May.

I had a bad reaction to Clomid, to put it lightly. I was on the lowest dose, and only produced one egg as a result, but I had a crippling headache that Tylenol didn’t even touch, and I felt crazy, like someone who might be arrested for knocking over a display in the post office or defacing political posters outside the VFW. The whole month, after I started the pills, I felt like someone who was one straw away from the proverbial broken back.

To up our chances, and cut out the Clomid crazies, our doctor suggested moving to Gonal F, an injectable medication that would increase egg production and give us almost double the chance of conceiving, 15 percent as opposed to 8 percent with oral meds. It sounded like a good deal to me, so we went for it.

The long and short of it was that we had to cancel my cycle, which put me in a quandary: did half a cycle count as our last-ditch effort? And regardless, did I want to go forward with another try?

My body, not to put too fine a point on it, is fucked up. Hopefully, if you’re reading this, you’re not squeamish, but if you are, now’s your chance to ditch. I’ll wait.

OK, still here? OK. So, this weekend, I started bleeding a bunch, about a week too early for my period. It also didn’t feel like my period. My periods come with pain, on a scale of Doubled-Over in Pain to Cancel Yo’ Plans, and weirdly, this one is pain-free. That would be good news, but there’s also a lot more blood than normal, and it’s not period-type blood.

If you’re not a uterus-haver, and don’t have a lot of experience with periods, I’ll explain it like this: ordinarily, when a period-having person has her moon-time, it’s very evident that tissue is departing the body. This is more like I’ve been stabbed.

I was understandably a little bit nervous about the whole, “Hey, have I been stabbed?” issue, so I called the office to see if they thought I was dying. Unfortunately, it was Sunday, so I had to leave a message for the nurse line. In fact, I left two messages. Then, I fumed for the rest of the day, as my phone remained dark and quiet.

It felt like I was dating again.

This morning, a nurse called me back and said that she’d left a message this weekend, which I’d never received. The message said that I should have come in this morning, but since we didn’t speak until after morning office hours were over, I’ll go in tomorrow.

She did not seem to think I was dying.

She did describe tomorrow’s appointment as “a baseline,” however, which filled me with anxiety, because “a baseline” is generally what you have at the beginning of a treatment cycle.

I don’t know yet if we’ll do another round, but I can tell you that I do not want to do one right away. I felt like garbage this month, especially after my brush with Ovarian Hyperstimulation Syndrome. My whole body hurt, my belly was swollen (ironically, like a someone entering her second trimester), and I had violent chills. I’m still not right in the head. I’ve been chasing a weird smell around the house for days now, which typically means one of two things: either I need to take out the garbage, or I’m getting depressed. The garbage situation is under control, so it’s probably the latter.

The best/worst part is, tomorrow’s appointment, which involves a transvaginal ultrasound, will have to be drug-free, as Adam is working and the state of New York would prefer it if I didn’t take Ativan and drive.

So, get ready, everyone. If you turn on the news and there’s a report of a woman running around Westchester, wearing only a paper drape from the waist down and shrieking, you won’t even have to look for my name. Just assume it’s me.

Back when I first started infertility treatments we were recommended to take Femara instead of Clomid, and it was the worst experience imaginable and I said I would never do it again – and didn’t. My entire body was in pain and I could barely move for several days. We actually went from 2 IUIs to donor egg IVF, bypassing traditional IVF when it was clear my eggs were practically non-existent. It’s not something I ever imagined I would be doing and after 4 failures, I have no idea if I never meant to get pregnant and stay pregnant. It all sucks no matter what decision we make and how far we decide to take the journey. The how much is enough question is definitely one I have pondered as well.

It’s really hard to know when to draw the line. I’m sorry you’re dealing with all this. It’s unbelievably hard. (Like, literally, I can’t believe it. I go around in a state of outrage a lot of the time, looking for the person who’s responsible for it.)